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NPI Code Detail

MEDICARE: DR. MEGHAN COLLEEN O'BRYAN MD

MEDICARE:  DR. MEGHAN COLLEEN O'BRYAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician9087SD

General Provider Information

NPI Number : 1417022393
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEGHAN COLLEEN O'BRYAN MD
Provider Business Mailing Address
First Line : 353 FAIRMONT BLVD
Second Line : ATTEN CHRISTIE MSS
City : RAPID CITY
State : SD
Zip : 57701-7350
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1445 NORTH AVE
Second Line :
City : SPEARFISH
State : SD
Zip : 57783-1552
Country : US
Telephone Number : 605-644-4170
Fax Number : 605-644-4198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2006
Last Update Date : 08/01/2014

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Directions to “ DR. MEGHAN COLLEEN O'BRYAN MD” Practice Location

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